The Covid pandemic has placed us in front of a complexity of challenges whose emergencies face time.
The time of science, the time of public management, the time of the individual management of our needs and the most basic needs of our daily life, including the time of our immediacy.
The ability to produce a sustainable public policy over time depends on various factors, such as coordination of actions, monitoring of living conditions and the impacts of public actions, production of knowledge and information, constant evaluation of results. and, finally, good communication with the population.
Health and good management of the health crisis
When defining what health is, health policies drive behavior – real control of individual and collective organs. They produce a flood of information, advice and data available to individuals – currently within the reach of mobile applications – to guide them in taking charge of themselves and the collective. Everything carefully calculated, planned and communicated.
The successful management of a social and health crisis caused by a pandemic necessarily requires the ability of governments to communicate, with the production and dissemination of information aimed at clarifying and guiding the behavior of populations. This requires objectivity and the transmission of precise information.
Since the start of the Covid pandemic, the world has been looking for ways and alternatives to ensure normalcy, even if it signals the promise of a ‘new normal’.
However, the search for normality prevents us from thinking in terms of rupture. Each crisis is a transformative power. However, the rupture that motivates the search for new forms of action, other parameters, new paradigms and utopias also plunges us into fear, anguish and mourning. Paralyzed, begging for the known. It keeps us in the management of the emergency.
The need to ensure normality has led to political speeches, public policy decisions, media debates and choices made by each of us.
In several countries, this is in addition to an anti-democratic public management guided by neoliberal principles: the urgency of the market, the erasure of social and fiscal austerity, the manipulation of individual and collective fears. A ruthless collective trap is set.
By focusing on the vaccination campaign and its benefits, and at the same time easing movement restrictions, allowing the reopening of schools and shopping centers, the government has encouraged the resumption of routine, potentiating the circulation of the virus, the proliferation of new strains and Contagion.
As a result, there has been an explosion in the occupancy rates of ICU beds, an exhaustion of teams and health professionals, and a transformation in the profile of their patients: they are increasingly young.
If before intensive care beds were occupied by the elderly and people at risk, the virus has found its way in those who no longer have immune resistance: young adults.
Despite the advance of vaccination in groups at risk, the lethality remains the same, since the virus has only migrated and adapted to a new group. Also, because they are younger, this group is made up of people who spend more time fighting for their lives when the disease worsens. As a result, they occupy intensive care unit beds for much longer, even when they die.
In short, the government sent the wrong message and people concerned with normalcy did not hesitate to integrate it.
The situation in Brazil
The vaccine has become a watchword in Brazil. The efforts and communication of governments have turned to vaccination, which gives a normal air to the passport.
But there is also the “opening and closing” of schools, shops, leisure areas, bars and restaurants.
Daytime outdoor activities are prohibited; the following week, they are only authorized individually; next week, as a group. The beaches are closing, but the bars and restaurants are open to the public.
Across the country, what we see is a back and forth of disparate recommendations based on local and fragmented logic, all focused on the effort to maintain routine and not displease the more powerful economic interests. And without any centralized coordination.
In the media, the number of ICU beds and vacancies is discussed as if it were an endless resource, regardless of budget or human resources.
As the case curve increases, the manager increases the number of beds. The bed occupancy rate is one of the main indicators used to set up the “phases” which indicate the severity of the pandemic that each municipality is going through (bed occupancy, case rate and mortality).
Indicators that have come to guide our daily life, when tariffs increase, restrictions increase, when they decrease, restrictions relax.
Worse yet, this back and forth of data and decisions seems to give us a fragile, but necessary, sense of predictability and control. After all, decisions are made with technical advice based on data monitoring.
And people get the message: if the bars, restaurants, malls, schools … are open, then I can go. Short-sighted risk management focused on standardization and driven by market urgency.
We are faced with decisions taken from parameters “irrelevant”, guided by ideas and values which are not able to shed light on the crisis we are going through, establishing a management of public policies that could well be defined. by the image of the dog running behind the tail itself.
As long as the communication on the risks of Covid and the prevention and behavior guidelines to avoid transmission and contagion are not clear, and the actions aimed at returning to a “normal life” that will never come, public management is limit to emergency management imposed by death row in hospital beds – an unpredictable escalation in the face of limited resources.
One day we will need beds, the next day for oxygen, after the sedatives, and tomorrow for increased casket production.
In addition to the risk of normalizing escalating mortality, the credibility of vaccination is at stake.
The trap is to make people believe that the vaccine is the main way out of a crisis which requires much more than actions and efforts carried out on the basis of an urgent logic.
The vaccine is only part of the solution. It must be accompanied by distance measurements, a long period of social isolation, the use of masks, mass tests and patient follow-up. Above all, by accepting that there has been a definitive break with the life we have lived.